title: Self-monitoring in hypertension: a web-based survey of primary care physicians.
abstract: Although self-monitoring of blood pressure is common among people with hypertension, little is known about how general practitioners (GPs) use such readings. This survey aimed to ascertain current views and practice on self-monitoring of UK primary care physicians. An internet-based survey of UK GPs was undertaken using a provider of internet services to UK doctors. The hyperlink to the survey was opened by 928 doctors, and 625 (67%) GPs completed the questionnaire. Of them, 557 (90%) reported having patients who self-monitor, 191 (34%) had a monitor that they lend to patients, 171 (31%) provided training in self-monitoring for their patients and 52 (9%) offered training to other GPs. Three hundred and sixty-seven GPs (66%) recommended at least two readings per day, and 416 (75%) recommended at least 4 days of monitoring at a time. One hundred and eighty (32%) adjusted self-monitored readings to take account of lower pressures in out-of-office settings, and 10/5 mm Hg was the most common adjustment factor used. Self-monitoring of blood pressure was widespread among the patients of responding GPs. Although the majority used appropriate schedules of measurement, some GPs suggested much more frequent home measurements than usual. Further, interpretation of home blood pressure was suboptimal, with only a minority recognising that values for diagnosis and on-treatment target are lower than those for clinic measurement. Subsequent national guidance may improve this situation but will require adequate implementation.
authors.affiliation: Primary Care Health Sciences, Radcliffe Observatory Quarter, University of Oxford, Oxford, UK.
authors.forename: R J
authors.initials: RJ
authors.lastname: McManus
authors.affiliation: Primary Care Clinical Sciences, University of Birmingham, Birmingham, UK.
authors.forename: S
authors.initials: S
authors.lastname: Wood
authors.affiliation: Primary Care Clinical Sciences, University of Birmingham, Birmingham, UK.
authors.forename: E P
authors.initials: EP
authors.lastname: Bray
authors.affiliation: Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia.
authors.forename: P
authors.initials: P
authors.lastname: Glasziou
authors.affiliation: Screening and Test Evaluation Program, School of Public Health, University of Sydney, Sydney, New South Wales, Australia.
authors.forename: A
authors.initials: A
authors.lastname: Hayen
authors.affiliation: Primary Care Health Sciences, Radcliffe Observatory Quarter, University of Oxford, Oxford, UK.
authors.forename: C
authors.initials: C
authors.lastname: Heneghan
authors.affiliation: Primary Care Unit, Institute of Public Health, University of Cambridge, Cambridge, UK.
authors.forename: J
authors.initials: J
authors.lastname: Mant
authors.affiliation: School of Clinical Sciences and Community Health, College of Medicine and Veterinary Science, University of Edinburgh, Edinburgh, UK.
authors.forename: P
authors.initials: P
authors.lastname: Padfield
authors.affiliation: Ageing & Stroke Medicine Section, Norwich Medical School, University of East Anglia, Norwich, UK.
authors.forename: J F
authors.initials: JF
authors.lastname: Potter
authors.affiliation: Primary Care Health Sciences, Radcliffe Observatory Quarter, University of Oxford, Oxford, UK.
authors.forename: F D R
authors.initials: FD
authors.lastname: Hobbs
mesh_terms: D001291:Attitude of Health Personnel; D001794:Blood Pressure; D001795:Blood Pressure Determination / Q000379:methods* / Q000592:standards; D005260:Female; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000503:physiopathology; D020407:Internet; D008297:Male; D010353:Patient Education as Topic; D010818:Practice Patterns, Physicians' / Q000592:standards; D011237:Predictive Value of Tests; D011320:Primary Health Care; D015203:Reproducibility of Results; D012648:Self Care / Q000592:standards; D011795:Surveys and Questionnaires; D006113:United Kingdom